While this is a question we get occasionally, it's always a disturbing question. It's akin to going to the service station and asking, "Sir, could you fill up the radiator and skip the gas?"

The physical examination is the most important part of a pet's visit to the doctor. Repeat after me, "The physical examination is the most important part of the visit."

Regular vaccinations are a crucial part of prevention of disease for all pets. Without them we return to the days of my youth, when puppies died horrible deaths in seizures with white and yellow pus draining from their noses as canine distemper raged through their respiratory and central nervous systems.

Or the early days of my practice in the '80s when parvovirus ravaged entire litters, entire households and entire kennels.

But, just as it is absurd to fill a car's radiator with water but leave the gas tank empty, it's equally ludicrous to decline an examination and vaccinate a pet.

Why is it ludicrous, you ask?

For starters, any disorder could cause your pet discomfort. Some of them could be fatal. And some could be fatal quickly, maybe even before the body could even respond to the vaccines.

Some disorders could also interfere with the immune system's ability to generate protection to the diseases we were trying to prevent, thus negating the whole purpose of giving "shots."

Recently a colleague told me just such a story. "A new client had a cranky cat that he didn't want to be stressed by an examination. He just wanted to get the shots and get the cat back home," my friend said.

Bruiser died a few days later.

Feeling guilty for not having Bruiser examined, the pet owner asked his new veterinarian to perform a post-mortem examination. The results showed Bruiser was afflicted with a condition known as hypertrophic cardiomyopathy (HCM). HCM results in heart muscle on the left side of the heart that becomes so big, strong and thick that it fills up the left ventricle, leaving little room for blood to fill that side of the heart to be sent out to the body.

The earliest signs of HCM a veterinarian might find in a routine examination include fast heart rate, irregular heartbeat and large round or valentine-shaped heart on a chest X-ray. A pet owner might notice a decrease in activity level and possibly panting. No normal cat should ever pant, regardless of the degree of exertion.

Uncooperative Bruiser would have required an examination last year in order to catch his disease early enough for treatment to help. He was in probably no better mood last November, having come to this owner as a feral kitten several years before.

Cardiac ultrasound, or echocardiography, is the gold standard for diagnosing HCM because ultrasound can show the practitioner the inside of the heart and not just the outline that an X-ray shows. Unfortunately for the Bruisers of the world, an ultrasound requires a lot of a patient's patience.

So, when your pet's doctor wants to start the visit with a thorough examination don't stand in his way. Show the love you have for your pet. The examination is, that's right, "the most important part of the visit."